Guidelines For Mass Casualty Decontamination - PowerPoint Presentation

Slide1

Guidelines For Mass Casualty DecontaminationSlide2

Provide operations personnel with an understanding of the effects of chemical and biological agents

Provide an understanding and demonstrate the need for mass decontaminationProvide operations personnel with a systematic approach to rescue actions at chemical incidents

ObjectivesSlide3

Biological

Living – Bacteria and Viruses

Living organisms that reproduce

May or may not be contagious

Plague, Small Pox &

ANTHRAX

Non-living – Toxins

Poisonous byproducts of microorganisms.

Not living or contagious

Venom, Botulinum (neurotoxin –fast acting)

Ricin (

cytotxin

– slower actingSlide4

Choking agents

Blister Agents

Blood Agents

Nerve Agents

Riot Control Agents

Mustard Agents

Psychotomimetic Agents

Toxins

Types of Chemical agentsSlide5

S- Salvation

L- Lacrimation

D- Defecation

G- Gastrointestinal

U- Urination

E- Emesis

M-

Miosis

Signs and symptoms of Chemical Agents

S.L.U.D.G.E. M.Slide6

Chemical release in Bhopal, India

Radioactive material release in Goiania, Brazil

Sarin Gas release in Tokyo, Japan

Three Historical Events that Demonstrate the Need for Mass DecontaminationSlide7

Bhopal, India

Bhopal

is

located in the northcentral region of India

Population

of

0.9 million in 1984Juncture of several major rail linesSlide8

Built and operated the pesticide plant

Ownership – 50.9% owned by Union Carbide

–

26% owned by the government

of

India

– 23.1% owned by citizens of IndiaOperating since 1969In 1979, began to produce its own methyl

iso

-cyanide, instead of importing itUnion Carbide IndiaSlide9

Occurred at night on December 23, 1984

40 tons of hydrogen cyanide and methyl

iso

-cyanide were released into the air

Covered

a 40

sq km area and hung closeto the ground for 4 hours500,000 people were exposed6,000

people died the first week, about

¾ of those in the first few hoursFew people received medical attentionThe DisasterSlide10

Union Carbide’s Bhopal PlantSlide11

Goiania, Brazil

Located 210 KM

west of

Brasilia

Population

of about

1 millionModern citySlide12

During the 1950’s the clinic had imported a

teletherapy unit for cancer treatments that

used cesium 137 as its source

In

the 1960’s cobalt therapy units

were imported

and became the standard, replacing the cesium unitThe old clinic was abandoned and eventually slated for demolition

Cancer Therapy ClinicSlide13

During the demolition of the clinic in 1984,

two scavengers found the cesium source

They

took it home and for four nights tried

to open

the lead container

Finally they broke the iridium window and the source emitted a brilliant blue glowEventually they broke the source openThe cesium chloride was spread by a number

of unknowingly

contaminated peopleThe DisasterSlide14

Teletherapy

unitmuch like the oneinvolved in the

Goiania, BrazilSlide15

Only 250 people were exposed to

the cesium28 people showed signs of

radiation sickness

104

had internal contamination

4

fatalities (2 men, a woman and a child)A number of people that handled the source received burns to the hands and chest

Luckily, Exposure was LimitedSlide16

Citizens wanted to be checked to

make sure they were not contaminated with the cesium

(This was coined as the

worried well

!)

People

were told to gather at a soccer stadium to be evaluated112,800 people came to the soccer stadium120 had contamination

Widespread Panic Gripped the CitySlide17

Tokyo, Japan

Capital of Japan

Population

8.1 million

Largest subway system

in the world

Shinjuku Station handles some 4,000,000 commuters dailySlide18

Japanese terrorist group based initially

on religious fanaticism, but developed into a

political group

Had

struck several times with

violence, including

a sarin gas attack in 1994, seven people died and hundreds were injured.In 1994, their compound had a serious gas leak and they evacuated for several days

Aum

ShinrikyoSlide19

10

Members of the cult released sarin

gas on

subway trains and in stations at

a predetermined

time

They used lunch boxes, thermoses and beverage containers to get the material into the subwaySlide20

The Emergency Response

131

Ambulance responded

1,364

medical personnel were dispatched

641

victims were transported to the hospitalOver 4,000 went on there own110 hospital staff and 135 EMS personnel suffered from secondary contaminationSlide21

Received 688 victims of the sarin

gas attackIf they had a decon facility…

–

That had four showers, and

–

Provided 5 minutes per

victim for decon – Could sustain this operation indefinitely,They

could decontaminate 48 victims

an hour and complete all 688 victims in 15 hoursSt. Luke’s International HospitalSlide22

People with continued exposure for

15 hours are going to suffer ill effectsHospital

and emergency responders

in protective

suits does nothing to calm

the situation

The potential for unrest and unruly victims increasesPeople are not going to wait 15 hours for decontamination

Drawbacks of Small

Decontamination FacilitiesSlide23

Time is critical

Provide effective mass casualty decontamination

Conduct decontamination triage prior to showering

When contamination involves chemical vapors, biological, or radiological material have patients use gentle friction with hands to remove contaminants

Do the most good for the most people

The Principles of Mass Casualty DecontaminationSlide24

Triage is the process of determining the priority of a victim’s treatment based on the severity of their condition. In this context, “Decontamination Triage” is a prioritization mechanism used by first responders to determine whether victims emerging from HAZMAT/WMD incident scenes should be directed to area(s) of safe refuge/observation or to a mass casualty decontamination station.

Definition of Decontamination TriageSlide25
Slide26

Victims are evacuated from the Hazard area

First responder performs decontamination triage. Victims with no apparent exposure to the hazard are sent directly to a safe/refuge observation area to monitor for delayed symptoms and signs of contamination

Victims with likely exposure are sent to the water shower deluge and undergo mass casualty decontamination

Mass Decontamination StationsSlide27

Following decontamination victims without additional visible symptoms are sent to a safe/refuge observation area for monitoring

Symptomatic and ambulatory victims undergo additional medical triage, treatment and are transported to a medical facility if requires for further medical treatment

Victims are released from the safe/refuge observation area or medical facility as directed

Mass Decontamination StationsSlide28

Water Shower DelugeSlide29

Nozzle Pressure should be maintained

at 60 psi…low pressure, high volumeRequires

three pump operators,

two nozzle

men and three firefighters to

direct victims

: – One instructing to disrobe – One guiding people into corridor – One guiding people to safe area after

decon

Mass Decontamination CorridorSlide30

Use of tarps can add a level of privacy

Notice overhead

shower is a

1.75”

nozzle attached

to a ladder that

straddles thedecontaminationcorridorSlide31

Have victims remain in shower for between 30 sec. to 3 min.

When possible separate males and femalesUse tarps to protect modestyQuickly dry and dress after decontamination

Communicate with patients

Continue monitoring victims for signs and symptoms

Mass Decon continuedSlide32

Example Mass DeconSlide33

Please direct all

questions, comments, or concerns to your department’s Training Officer or

HazMat

techs.

Train

Hard! -

Do

Work!

The End